手术治疗髋臼骨折的临床疗效观察.doc

手术治疗髋臼骨折的临床疗效观察 富顺县人民医院 张发平1 李玉桥2 罗仕武 1 何罗彬 1 杨勇1 尚庆1 胡晓刚1 [摘要] 目的 初步探讨手术治疗髋臼骨折的临床疗效，并对相关因素进行分析。 方法 对2007年1月-2012年5月收治的移位的髋臼骨折48例，所有骨折均按Judet-Letournel分类，简单骨折18例，复杂骨折30例，其中后壁骨折12例，后柱骨折3例，前柱骨折1例，后柱伴后壁 13例，横行伴后壁骨折10例，双柱骨折9例。分别采用Kocher-Langenbeck入路，髂腹股沟入路，前后联合入路行切开复位骨盆重建钢板、螺钉内固定。结果 随访48例，按matta影像学评分，解剖复位28例，满意复位14例，复位较差6例，按改良的Merled’s Aubigne和Postel评分标准，优 28 例，良9例，可7例，差4例。简单骨折组和复杂骨折组临床优良率分别为94.4%和66.7% ，解剖复位组和非解剖复位组的临床优良率分别为96.4%和50%，比较均有统计学差异（P〈0.05） 并发症包括：创伤性髋关节炎，异位骨化，坐骨神经损伤，伤口感染，股骨头缺血坏死。结论 手术治疗髋臼骨折可获得满意的疗效，其中骨折的复位质量，骨折类型与疗效之间有重要关系。 关键词 髋臼骨折；骨折固定术，内；切开复位； Surgical treatment acetabulum fracture clinical curative effect observation ZHANG Fa-ping,LI Yu-qiao ,LUO Shi-wu ,HE Luo-bin ,YANG Yong ,SHANG Qing, HU Xiao-gang FuShunXian sichuan province peoples hospital orthopaedic Fushun 643200,China [Abstract] Methods Analyse 48 cases shift of the acetabulum fracture from 2007 January to 2012 May，and all fractures are at Judet - Letournel classification,there are 18 cases of simple fracture, 30 cases of complicated fracture ,among them posterior wall fracture 12 cases, after column fracture 3 cases ,anterior column fracture 1 case, posterior column and posterior wall fracture 13 cases, transverse with back wall fracture 10 cases, double column fracture 9 cases.Respectively by means of Kocher - Langenbeck into the road, iliac inguinal into the road, and the combined road line open reduction pelvic reconstruction plate, screw inside fixed.Results Follow-up the 48 cases, according to the anatomical reattachment matta imaging score, 28 cases were satisfied with reset 14 cases, reset poor 6 cases, according to the improved Merled s Aubigne and Postel rating standards, optimal 28 cases, good 9 cases,tolerable 7 cases, poor 4 cases.Simple fractures clinical excellent and good rate was 94.4% and complex fractures clinical excellent and good rate was 66.7% .Anatomy reset group and non anatomy reset group of clinical rate were 96.4% and 50% respectively,those compares ha